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Charging Older Adults Higher Premiums Could Cost Taxpayers

The Affordable Care Act (ACA) requires that health insurers make coverage accessible and affordable to all individuals, regardless of age, gender, or health status. Under the ACA, people age 64 and older cannot be charged more than three times as much as 21- to 24-year-olds for the same plan (this is known as 3-to-1 “rate banding”). In general, this rule reduces premiums for older enrollees, while raising costs for younger enrollees. While the goal of the regulation is to make insurance affordable for all age groups, critics argue that it discourages young, healthy people from enrolling…

Christine Eibner is a senior economist at the nonprofit, nonpartisan RAND Corporation. Evan Saltzman is a graduate student at the Wharton School at the University of Pennsylvania, and a project associate at RAND.

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